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<title>BSS PATIENT ID CARD</title>
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			<font size="6">CANCER CARE HOME</font>
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			<font size="4">BHARAT SEVASHRAM SANGHA</font>
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			<font size="2">263, SWAMY PRANAVANANDAJI MARG,SECTOR-31A, VASHI,NAVI MUMBAI-400703 </font>
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			<font size="4" >TEL.:</font><font size="4">2781-1327</font> <font size="4"></font><font size="4"></font>
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			<strike>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
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			<font size="5">ID CARD</font>
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									photo
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						SL.NO:
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						xxxx
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						ROOM NO:
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						xxxxxxxxxxxxxxxx
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						DATE:
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						XX/XX/XXXX
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						NAME:
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						xxxxxxxxx xxxxxxx xxxxxxx
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						ADDRESS:
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						xxxxxxxxxx
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						CASE NUMBER:
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						xxxxxxxxxx
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						SECURITY DEPOSIT:
					
						Rs xxxx/-
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						NO OF PERSONS:
					
						1+2+3=6
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						PERIOD OF STAY FROM:
					
						XX/XX/XXXX
						
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						PERIOD OF STAY TO:
					
					XX/XX/XXXX
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						Ext:_ _/_ _/_ _ _ _ Ext.:_ _/_ _/_ _ _ _
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						Ext:_ _/_ _/_ _ _ _ Ext.:_ _/_ _/_ _ _ _
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						Ext:_ _/_ _/_ _ _ _ Ext.:_ _/_ _/_ _ _ _
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						Ext:_ _/_ _/_ _ _ _ Ext.:_ _/_ _/_ _ _ _
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						Ext:_ _/_ _/_ _ _ _ Ext.:_ _/_ _/_ _ _ _
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						Ext:_ _/_ _/_ _ _ _ Ext.:_ _/_ _/_ _ _ _
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						Ext:_ _/_ _/_ _ _ _ Ext.:_ _/_ _/_ _ _ _
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						Ext:_ _/_ _/_ _ _ _ Ext.:_ _/_ _/_ _ _ _
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						MATERIALS ISSUED
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								DBS=XX
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								SBS=XX
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								DMN=XX,
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						 		SMN=XX
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						 		BKT=XX
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						 		 MG=XX,
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								LK=XX
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								MlkTkt=XX
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								OTHERS1
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								XXXXXX
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								OTHERS1
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								XXXXXX
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						UTENSIL SET ISSUED:
						
						SET I/SET II
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						UTENSIL SECURITY:
						
						xxxxxxx
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			Secretary &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
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						PLEASE RETURN THIS CARD
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						AT THE TIME OF DEPARTURE
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						<H3>MAIN GATE CLOSES AT 11 P.M.</H3>
						
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